Rhetoric of a Global Epidemic
How we communicate about disease can have consequences for prevention and treatment. Scott McLemee consults a new book on a recent epidemic.
Three people in the United States have contracted the Middle East Respiratory Syndrome coronavirus, so far -- two while traveling abroad, the third through contact with one of them. Another 600 or so cases have been diagnosed elsewhere in the world since MERS first appeared in early fall of 2012, according to the World Health Organization.
Or rather, that many cases are now confirmed. It could well be that more people have had MERS (wherever in the world they may be) and endured it as if a terrible flu; it’s also possible to be exposed to it and develop antibodies without showing any of the symptoms. With a new disease, solid information tends to spread more slowly than the vectors carrying it. Some of the online news coverage calls the disease “highly contagious.” But that doesn’t really count as solid information: while MERS has proven fatal about a third of the time, it seems not to be readily transmissible in public settings.
No travel advisory has been issued, nor are special precautions being recommended to the general public, though health care workers are vulnerable. The Centers for Disease Control and Prevention suggests washing your hands regularly and keeping them away from eyes, nose, and mouth as much as possible -- hygiene recommendations of the most generic sort.
But the fearsome label “highly contagious” became almost inevitable when MERS was branded with a name so close to that of Severe Acute Respiratory Syndrome. For SARS was highly contagious; that’s what made it so terrifying. I use the past tense because no new cases have been reported in 10 years. The rapid spread of SARS was halted, and in its wake international efforts to monitor and exchange information about emerging diseases have improved.
MERS ≠ SARS. Even so, its very name calls up the specter of a quick-moving, lethal, and global pandemic. And those connotations insinuate themselves into discourse on the new disease -- as if to ready us for panic.
Well, don’t. That would be premature. (Try not to lick doorknobs or French-kiss anyone with a wracking cough, and you’ll probably be just fine.) The start of the 21st century may well be what CDC director Thomas Friedan has called the "perfect storm of vulnerability”: unknown new diseases can continent-hop by airplane and test their strength against antibiotics that have become ever less effective, thanks to overuse. But humans can think while viruses cannot, and it seems at least possible that could prove the decisive advantage.
Consider a new book from Southern Illinois University Press called Rhetoric of a Global Epidemic: Transcultural Communication about SARS by Huiling Ding, who is an assistant professor of professional and technical communication at North Carolina State University. It is a work of some factual and conceptual density, but I suspect it will play some role in how information about disease outbreaks will be organized and delivered in the future.
Ding has not set out to write the history of SARS, but she does reconstruct and scrutinize how bureaucracies and mass media, both east and west, communicated among themselves and with their publics as the disease emerged in China in November 2002 and began spreading to other countries in the new year. Her analytical tool kit includes elements of classical (even Aristotelean) rhetoric as well as a taxonomy of kinds of cultural flow based on Arjun Appadurai’s anthropology of globalization.
The author prefers to identify her approach as "critical contextualized methodology,” but for the purpose of making introductions we might do better to dwell on a single guiding distinction. Ding is wary of a number of established assumptions implied by the term "intercultural communication,” the very name of which implies two or more distinct cultures, standing at a certain distance from one another, exchanging messages. When things are so configured, “culture” will sooner or later turn out to mean, or to imply, “nation” -- whereupon “state” is sure to follow.
By contrast, "transcultural communication” drags no such metonymic chain behind it. It has a venerable history, with roots in Latin American cultural studies. “Transculturation,”writes Ding, “can be used to describe a wide range of global phenomena, including exile, immigration, multicultural contact, ethnic conflicts, interracial marriages, overseas sojourns, and transnational tourism.” A transcultural perspective focuses on layers and processes that constitute different societies without being specific to any one of them, and that can themselves be in flux.
So, to choose a SARS-related example, referring to "Chinese mass media” will, for most Americans, evoke a relatively simple-seeming concept -- one that involves messages in a single language, circulated through certain well-established forms of transmission (newspapers, radio, television) among a population of citizens living within the borders of a nation-state (presumably the PRC). I dare say “American mass media” has analogous implications for people in China, or wherever.
But whatever sense that outlook once might have made, it now distorts far more than it clarifies. The range and the audience of mass media are in constant flux; the messages they transmit do not respect national borders.
“My research,” Ding said in an email interview, "shows different values and practices of traditional newspapers housed in Beijing and Guangzhou (mainstream and commercial ones) despite the exertion of censorship during the early stage of SARS.” The People’s Daily, official mouthpiece of the Chinese leadership, remained silent on the health crisis until as late as March 2003. But by January 2003, regional newspapers in small cities began reporting on the panic-buying of antiviral drugs and surgical masks -- information that then became known elsewhere in the country, via the Internet, as well as to “overseas Chinese” around the world, well before the crisis was international news.
Ding also discusses the “ad hoc civic infrastructure” that sprang up during the outbreak, such as the website Sosick.org, which engineers in Hong Kong created to circulate information about local SARS cases and encourage voluntary quarantines. "Concerned citizens can learn from coping strategies from other cultures,” she said by email, "be it communities, regions, or countries, and adapt such strategies to cope with local problems. For instance, I am working on another project on quarantine policies and practices during SARS in Singapore, mainland China, Hong Kong, Taiwan, and Canada…. Such bottom-up efforts often carry persuasive power, and in the case of Hong Kong, did help to introduce policy changes.”
Her reference to “persuasive power” is a reminder that Ding’s book belongs to the tradition of rhetorical scholarship. She devotes part of the book to an analysis of enthymemes in official Chinese commentaries on the crisis, for example. (An enthymeme is a deductive argument in which one of the assumptions goes unstated.) That a grassroots quarantine movement on two continents proved more successful and persuasive than state-sanctioned efforts to maintain social order is easy to believe.
What we need, Ding told me, are analyses of the "communication practices of global and/or flexible citizens, or multi-passport holders who regularly travel across continents in search of fame, wealth, or influence. Their familiarity with multiple cultures certainly introduce interesting transcultural communication strategies.” That bottom-up appeals for quarantine proved effective in a number of countries suggests she could be right: cultivating new skills in communication and persuasion might well be crucial for dealing with other public health crises, down the line.
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Professor or Associate Professor of French and West African Francophone Studies and Director of the African-American Studies Program